Objective To investigate the clinical effect of acupuncture combined with mindfulness-based cognitive therapy (MBCT) in the treatment of premenstrual syndrome (PMS). Methods A total of 130 patients with PMS were randomly divided into acupuncture group with 43 patients, MBCT group with 43 patients, and acupuncture+MBCT group with 44 patients. Four patients in the acupuncture group, four in the acupuncture+MBCT group, and three in the MBCT group were lost to follow-up. For the patients in the acupuncture group, acupuncture was performed at Baihui, Shenting, Mingmen, Yaoshu, Yaoyangguan, Guanyuan, Zhongwan, and Zhongji points in the supine position and the prone position, with 15 minutes for each acupoint, twice every week; the patients in the MBCT group were given MBCT once a week; the patients in the acupuncture+MBCT group were given acupuncture combined with MBCT. Each course of treatment was 8 weeks, and each group was treated for one course. Shortened Premenstrual Assessment Form (SPAF) was used to evaluate the improvement in the symptoms of PMS, and State-Trait Anxiety Inventory was used to assess the changes in State Anxiety Inventory (S-AI) and Trait Anxiety Inventory (T-AI) scores after treatment. Results After treatment, all three groups had significant reductions in the total score of SPAF and the scores of its affective factors, edema factors, and pain factors as well as the total scores of S-AI and T-AI (P<0.05), and there was a significant difference in the degree of such reductions between the three groups (P<0.05), with the greatest reductions in the acupuncture+MBCT group. Conclusion Acupuncture combined with MBCT has a better clinical effect than acupuncture or MBCT alone in the treatment of PMS.